Specializing in Behavioral Healthcare for Children &

Adolescents, Families, Couples, and Adults. 












Severe trauma in childhood often has an enduring effect into adulthood. Past trauma includes experiences such as sexual and physical abuse, the death of a parent or sibling, a natural disaster, divorce, or other major life event. 


Child sexual abuse is one of the most common traumatic experiences that can have a lasting effect into adulthood.  About 80,000 new cases of child sexual abuse are reported in our country each year, with a disproportionate number of the victims being female.   This number does not reflect the true incidence of child abuse, however,  due to the large number of cases that go unreported. 


Child sexual abuse is generally defined as forcible touching of the breasts or genitals, or forcible intercourse (including anal, oral, or vaginal sex) before the age of 16.  Epidemiological research shows that 15 to 33 percent of females and 13 to 16 percent of males are sexually abused in childhood, although the actual percentage vary based on the definition that is used.  The average age of a child at the time sexual abuse is first experienced is estimated at 7 to 9 years of age. In over 25 percent of cases of child sexual abuse, the offense was committed by a parent or parent substitute.


The long-term consequences of past childhood sexual abuse are profound, yet vary in expression. They range from depression and anxiety to problems with social functioning and adult interpersonal relationships. Post-traumatic Stress Disorder (PTSD) is a common sequela, found in 33 to 86 percent of adult survivors of child sexual abuse. In a recent review, researchers found that sexual abuse was a specific risk factor for adult-onset depression and twice as many women as men reported a history of abuse. Other long-term effects include self-destructive behavior, social isolation, poor sexual adjustment, substance abuse, and increased risk of revictimization. 


The long-term emotional and psychological damage of sexual and physical abuse and other emotional trauma can be devastating, and often are not manifested until adolescence or early adulthood.  Individuals who have experienced abuse often experience problems with depression, anxiety, substance abuse, and difficulty establishing and maintaining intimate relationships.  Without appropriate treatment, individuals who have been abused can experience a lifetime of problems.  Early identification and treatment is critical to minimize the long-term consequences of abuse. 


Individuals who have experienced abuse may display:


· Symptoms of Anxiety

· Symptoms of Depression

· Low self-esteem and poor self image

· Sexual acting-out (i.e., promiscuity or sexually-reactive behavior)

· Distorted ideas about sexual behavior

· Relationships difficulties related to trust issues

· Explosive anger or rage

· Aggressive behavior

· Self-destructive behavior

· Thoughts of suicide

· Social withdrawal and isolation

· School problems

· Flashbacks, unwanted thoughts, and/or nightmares

· Substance abuse


Young children who have experienced sexual abuse may display:


· An age-inappropriate preoccupation with sexual issues

· An avoidance of anything related to sex

· Sleep problems or nightmares

· Symptoms of depression

· Sexually seductive behavior

· Feelings that their body is dirty or damaged

· Feelings that there is something wrong with their genitals

· Refusal to go to school

· Delinquency or conduct problems

· Secretiveness

· Aspects of sexual molestation in drawings, games, fantasies

· Unusual aggressiveness, or

· Thoughts of suicide or attempts of self-harm


If your son or daughter discloses that he or she has been molested, you should try to remain calm and reassure your child that what happened was not his or her fault.  Parents should seek a medical examination and psychiatric consultation.


Parents can prevent or lessen the chance of sexual abuse by:


· Teach your child about appropriate physical boundaries—”good touches” and “bad touches.”  For example, if a child has a physical problem in their genital area, only a parent or medical doctor should examine them. 

· Teach your child to say, “No!” to anyone who tries to touch them in their private area, and to then tell you about it right away. 

· Teach your child that respect for adults does not mean being blindly obedient to everything an adult says to do. 


Sexually abused children and their families need immediate professional evaluation and treatment. Child and adolescent psychiatrists can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, and begin the process of overcoming the trauma. Such treatment can help reduce the risk that the child will develop serious problems as an adult.


When a child tells an adult that he or she has been sexually abused, the adult may feel uncomfortable and may not know what to say or do. The following guidelines should be used when responding to children who say they have been sexually abused:


What to Say If your child tells you that sexual abuse has occurred, encourage him or her to talk freely. Don't make judgmental comments.  Show that you understand and take seriously what the child is saying. Child and adolescent psychologists have found that children who are listened to and understood do much better than those who are not. The response to the disclosure of sexual abuse is critical to the child's ability to resolve and heal the trauma of sexual abuse.  Also, assure the child that they did the right thing in telling. A child who is close to the abuser may feel guilty about revealing the secret. The child may feel frightened if the abuser has threatened to harm the child or other family members as punishment for telling the secret.  Next, tell the child that he or she is not to blame for the sexual abuse. Most children in attempting to make sense out of the abuse will believe that somehow they caused it or may even view it as a form of punishment for imagined or real wrongdoings.  Finally, let your child know that you will provide protection from the abuse, and help in dealing with it.  Contact a child psychologist who specializes in working with alleged victims of abuse. 


What To Do

Report any suspicion of child abuse. If the abuse is within the family, report it to the local Child Protection Agency. If the abuse is outside of the family, report it to the police or district attorney's office. Individuals reporting in good faith are immune from prosecution. The agency receiving the report will conduct an evaluation and will take action to protect the child.


Parents should consult with their pediatrician or family physician, who may refer them to a physician who specializes in evaluating and treating sexual abuse. The examining doctor will evaluate the child's condition and treat any physical problem related to the abuse, gather evidence to help protect the child, and reassure the child that he or she is all right.


Children who have been sexually abused should have an evaluation by a child and adolescent psychiatrist or other qualified mental health professional to find out how the sexual abuse has affected them, and to determine whether ongoing professional help is necessary for the child to deal with the trauma of the abuse. The child and adolescent psychiatrist can also provide support to other family members who may be upset by the abuse.


While most allegations of sexual abuse made by children are true, some false accusations may arise in custody disputes and in other situations. Occasionally, the court will ask a child and adolescent psychiatrist to help determine whether the child is telling the truth, or whether it will hurt the child to speak in court about the abuse.


Remember, the first step in getting help when a child discloses that he or she has been abused is to give a supportive and caring response so that the child can begin to reestablish trust in adults.


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Telephone: 509-910-0329




Copyright © 2004-2007 Robert M. Newell, Ph.D. All rights reserved.